Jewell K Waldbaum in Spring Valley - Clinical
Jewell K Waldbaum - NPI 1124024005
Jewell K Waldbaum is a Clinical in Spring Valley, New York. Jewell K Waldbaum practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jewell K Waldbaum is 1124024005. The last update date is 2010-12-09.
Jewell K Waldbaum's current location address is 12 Hawk St, Spring Valley, New York. You can contact this provider via phone number 8453566329 and fax number 8454250144. The mailing address for Jewell K Waldbaum is 12 Hawk St, Spring Valley, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jewell K Waldbaum |
|---|---|
| Address | 12 Hawk St, Spring Valley, New York |
| Phone Number | 8453566329 |
| Fax Number | 8454250144 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1124024005 |
|---|---|
| Provider Enumeration Date | 2005-06-24 |
| Last Updated Date | 2010-12-09 |
Provider Mailing Address Detail
| Address | 12 Hawk St |
|---|---|
| City | Spring Valley |
| State | New York (NY) |
| Post Code | 109776104 |
| Phone Number | 8453566329 |
| Fax Number | 8454250144 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 3934 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 81767 | GHI IDENTIFICATION NUMBER | ||
| 3934 | NY | NEW YORK STATE LICENSE |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Jewell K Waldbaum by the Centers for Medicare & Medicaid Services?
The Jewell K Waldbaum has been assigned the NPI (National Provider Identifier) 1124024005 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Jewell K Waldbaum is located?
The Jewell K Waldbaum is situated at the following address: 12 Hawk St, Spring Valley, NY, 109776104.
What is Jewell K Waldbaum's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jewell K Waldbaum's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1124024005 to Jewell K Waldbaum?
The Centers for Medicare & Medicaid Services assigned the 1124024005 to Jewell K Waldbaum on 2005-06-24.
When was the information related to Jewell K Waldbaum most recently updated or refreshed?
The details pertaining to the Jewell K Waldbaum, including its address, specialty, and other relevant information, were last updated or refreshed on 2010-12-09.